Posts for: December, 2013

When it comes to dental health, you might say celebrity interior designer and television host Nate Berkus is lucky: Unlike many TV personalities, he didn't need cosmetic dental work to achieve — or maintain — his superstar smile. How did he manage that? Nate credits the preventive dental treatments he received as a youngster.

“I'm grateful for having been given fluoride treatments and sealants as a child. Healthy habits should start at a young age,” he told an interviewer from Dear Doctor magazine. We couldn't have said it better — but let's take a moment and examine exactly what these treatments do.

Fluoride treatment — that is, the topical (surface) application of a concentrated fluoride gel to a child's teeth — is a procedure that's often recommended by pediatric dentists. Although tooth enamel is among the hardest substances in nature, fluoride has been shown to make it more resistant to tooth decay. And that means fewer cavities! Studies show that even if you brush regularly and live in an area with fluoridated water, your child could still benefit from the powerful protection of fluoride treatments given at the dental office.

Another potent defense against cavities is dental sealants. Despite your child's best efforts with the toothbrush, it's still possible for decay bacteria to remain in the “pits and fissures” of the teeth — those areas of the molars, for example, which have tiny serrated ridges and valleys where it's easy for bacteria to grow. Dental sealants fill in and protect vulnerable areas from bacterial attack, greatly decreasing the risk that future dental treatment will be required.

Why not take a tip from our favorite celebrity interior designer, and ask about cavity-preventing treatments for your children's teeth? If you would like more information about fluoride treatments or dental sealants, please contact us for a consultation. You can learn more in the Dear Doctor magazine articles “Topical Fluoride” and “Sealants for Children.”

There’s more to orthodontics than simply moving teeth. Especially with children and adolescents, we also want to guide the development of the entire facial structure to solve certain types of malocclusions (poor bites).

One such concern involves the upper jaw and palate (roof of the mouth), known collectively as the maxilla. In some individuals, the maxilla is narrower than normal. This causes the upper teeth to fit abnormally inside the lower teeth when occluding or “biting down” and is known as a cross-bite. A cross-bite may restrict the amount of space for your teeth to erupt (appear in the mouth) in proper alignment. It can be so severe the individual may have to shift the jaw to one side to completely bite down.

If a cross-bite is caught early, there’s a non-surgical treatment to widen the maxilla and help prevent upper teeth misalignment. But there’s a limited time window of opportunity: this is because the maxilla is actually formed by two bones with a seam that runs down the middle of the palate. The two bones will eventually fuse, usually at the beginning of puberty; until then there’s a slight separation.

Before the bones fuse, we can use a palatal expander to widen this seam and encourage permanent bone growth in the resulting gap. The expander is made of two metal halves joined in the middle by a small screw device that fits between the teeth. You or your child turns the screw a very small amount once or twice a day with a special key and the action pushes the maxilla outward on either side: the slight tension created stimulates bone growth. Over time, the new bone will have added width to the maxilla and eliminated the cross-bite.

While it’s possible to correct this after the maxilla fuses, it will require surgery to separate the bones. The palatal expander helps us correct the problem in the most non-invasive way possible, but it must be done before puberty. Discovering this type of malocclusion early is one of many reasons why regular dental visits should be an important part of your child’s healthcare.

During most of your life, your dental healthcare will be mainly provided by your general dentist. Sometimes, though, certain situations and conditions call for the skills of a dental specialist. One such specialist is an oral surgeon.

An oral surgeon is a dentist who has undertaken further training and residencies in the practice of oral surgical procedures and treatments. They are especially distinguished by surgical procedures that may require advanced forms of anesthesia.

The field of oral surgery touches on a wide array of conditions. They are adept at tooth extractions, especially difficult cases like impacted teeth, and surgical procedures that correct issues involving the underlying bone of the jaw. They perform procedures as part of treatment for diseases of the jaws or facial region (including biopsies, and the removal and treatment of oral cancers), reconstructive surgeries of the mouth and jaw following disease or injury, and orthognathic surgeries that correct malocclusions (bad bites) caused by the size of the jaw and its placement with the skull.

Oral surgeons also provide treatments in the area of pain management like temporo-mandibular disorder (TMD), a group of conditions involving the joint that connects the lower jaw with the skull. Because of their background training in oropharyngeal (pertaining to the back of the mouth and the throat) physiology, many oral surgeons have received further training in the diagnosis and treatment of obstructive sleep apnea (OSA). They also play an important role in cosmetic dentistry, as with the surgical placement of dental implants.

All in all, these professionals are an important part of your dental healthcare team. Along with your general dentist and other oral specialists, they’re committed to helping you gain the highest degree of dental health possible, as well as a vibrant, healthy smile.

There’s more to tooth loss than you might think. Because teeth are part of a larger system that facilitates speaking, eating and digestion, a lost tooth could eventually affect your overall health.

Tooth loss is actually about bone loss. As living tissue, bone continually reforms in response to stimuli it receives from the body. The alveolar bone (which surrounds and supports the teeth) receives such stimuli as the teeth chew and bite, as well as when they contact each other. All these stresses — hundreds a day — transmit through the periodontal ligament to the bone, stimulating it to grow and remodel.

A lost tooth reduces this stimulation and causes the alveolar bone to resorb (dissolve) — as much as 25% of its width the first year alone. Unless the process is stopped, the underlying basal bone and the periodontal (gum) tissue will begin to resorb too. Without this structural support the facial height shrinks and the front teeth begin to push forward, making chewing and speaking more difficult. These teeth begin performing functions outside their normal range, leading to damage and possible loss.

The primary goal of oral hygiene and dental care is to prevent tooth loss. When tooth loss does occur, however, it’s then important to restore the lost tooth with an artificial replacement if at all possible — not only to regain form and function, but to also stop further bone loss.

While the fixed partial denture (FPD), also known as a fixed bridge, has been the restoration of choice for many decades, dental implants may be the better long-term option. Although more expensive initially, implants can achieve a life-like restoration without involving or altering adjacent teeth as with FPDs. Plaque retention and tartar accumulations are much less likely with an implant, and the bone-loving quality of titanium, the metal used for implants, actually encourages bone growth. As a result, implants have a much higher longevity rate than FPDs.

Taking care of your teeth through effective hygiene practices and regular checkups may help you avoid tooth loss altogether. But if it can’t be avoided, restoring lost teeth is the single most important thing you can do to prevent even greater problems down the road.